Treatment options for ankle fractures often depend on the location of the fracture, but generally speaking, there are surgical and nonsurgical treatments available, and based on the location and severity of your injury, you and your doctor can figure out what’s best for your individual case.
For a fracture of the fibula called a lateral malleolus fracture, surgery may not be needed, and your doctor may try to protect the fracture by, for instance, having you wear high-top shoes or a short leg cast. Doctors may also take frequent x-rays in the six or so weeks it will take the bone to heal to ensure that the fracture fragments have not moved out of alignment. If, however, the fracture is out of place or the ankle is unstable, surgery may be used. The surgeon will use a plate and screws on the side of the bone or a screw or rid inside the bone to keep the ankle stable and realign the bone fragments to keep them together as they heal.
For medial malleolus fractures that are not out of place or are very low fractures that have small pieces, surgery is not needed, and your doctor may prescribe a short leg cast or removable brace and advise you to not put weight on the ankle for six weeks. Again, repeated x-rays may ne needed to make sure the fracture’s position doesn’t change. Surgery in this case also involves the use of screws, a plate and screws, or wiring techniques to hold the bones together. In some cases, bone grafting may be needed to repair an indention of the ankle joint, which can reduce your risk of developing arthritis later on.
A posterior malleolus fracture, or a fracture of the back of the shin bone at the level of the ankle joint, is usually not an isolated injury, and in many cases the lateral malleolus or medial malleolus is also fractured. With this injury, the back of the ankle may sometimes be unstable and require surgery. Surgical options include screws placed front to back (or vice versa) on the ankle or to have a plate and screws placed along the back of the shin bone. If surgery isn’t needed, a short leg cast or removable brace may be recommended.
In a bimalleolar fracture, two of the three parts of the ankle are broken; in a bimalleolar equivalent fracture, the ligaments on the inside of the ankle are injured along with another part of the ankle. These are unstable fractures that can be associated with an ankle dislocation. Nonsurgical treatments are usually employed for bimalleolar or bimalleolar equivalent fractures if the patient has serious health problems; in these cases a splint is used until the swelling goes down, and then a short leg cast is placed on the leg. Surgery, which is more common for these fractures, uses screws and plates, just like surgeries for other ankle fractures.
Finally, for trimalleolar fractures, or fractures where all three parts of the ankle are broken, treatment options are similar as for the other types of fracture. Surgery is usually used, unless the patient has significant health problems or does not walk.